Experts recommend innovation for children's medicines

WHO 15th essential medicines list published today

16 April 2007 -Following recommendations from the Expert Committee on Essential Medicines, the World Health Organization (WHO) will immediately begin work to create a medicines list specifically tailored to children's needs. A group of experts will meet in July 2007 to produce the first international list of medicines to tackle diseases with high mortality and morbidity rates in children.

The Expert Committee made the recommendation while meeting on 19-23 March in Geneva to update the general WHO Model List of Essential Medicines. The list will be published today and already includes some child specific medicines.

Children suffer from the same illnesses as adults but they are more seriously affected - particularly in developing countries - by certain conditions such as respiratory tract infections, malaria and diarrhoeal diseases. An estimated 10.6 million children under five die every year, many from these treatable conditions. In 2005, 2.3 million children under 15 years were HIV positive - 700 000 new infections had occurred over the twelve months.

In spite of the huge need, there are few medicines made to measure for children or that can be easily consumed by a child. At present, children must often take portions of adult tablets in a crushed form, with little evidence of the efficacy and safety of the dose. When medicines do exist in the right dosage they are usually in syrup form, which may pose supply, storage and pricing problems in developing countries.

The challenge for children becomes more acute when they are affected by a condition requiring combination therapy (several medicines rather than one) such as for HIV/AIDS and malaria. In these cases, fixed dose combination tablets are required (two- or three-in-one pills). While production of adult fixed-dose-combinations is increasing, it is sorely lacking for children. In addition, antiretrovirals for children are currently three times more expensive than the adult versions.

The recommendation made by the Expert Committee for an essential medicines list for children will see WHO working with partners to advocate innovation and research into children's medicines, the manufacture of new dosage forms and new formats, and ways in which information about children's medicines can be conveyed to countries in a rapid, effective way.

The plan to work on better medicines for children was backed by Member States at WHO's Executive Board meeting in January this year and will be on the agenda of the World Health Assembly in May.

The Expert Committee made a number of important updates to the WHO Model List of Essential Medicines. Five fixed-dose-combinations for adults were included for HIV/AIDS. Two of these come from the generic industry while the remaining three are produced by brand name companies. All WHO recommended antimalarials were also added.

Five oral liquid formulations were included for children - three for epilepsy, one for children born prematurely, and one new medicine for HIV/AIDS, although in single dose. Three other epilepsy medicines were included in the form of chewable, dispersable tablets, a format which evidence increasingly shows to be effective for children.

The WHO List of Essential Medicines provides a model for countries to select medicines addressing public health priorities according to quality, safety and efficacy standards. It helps governments address problems of cost and availability and provides guidance to the pharmaceutical industry on medicines needs globally.